1. Where do you curently live?

2. What is your gender?

3. What is your age?

4. Are you now married, widowed, divorced, separated, or never married?

5. Which of the following categories best describes your employment status?

6. Which of the following best describes your current occupation?

7. Which race/ethnicity best describes you? (Please choose only one.)

8. What is your approximate average household income?